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https://www.readbyqxmd.com/read/28799620/long-term-bleeding-risk-prediction-in-real-world-patients-with-atrial-fibrillation-comparison-of-the-has-bled-and-abc-bleeding-risk-scores-the-murcia-atrial-fibrillation-project
#1
María Asunción Esteve-Pastor, José Miguel Rivera-Caravaca, Vanessa Roldan, Vicente Vicente, Mariano Valdés, Francisco Marín, Gregory Y H Lip
Risk scores in patients with atrial fibrillation (AF) based on clinical factors alone generally have only modest predictive value for predicting high risk patients that sustain events. Biomarkers might be an attractive prognostic tool to improve bleeding risk prediction. The new ABC-Bleeding score performed better than HAS-BLED score in a clinical trial cohort but has not been externally validated. It was the aim of this study to compare the predictive performance of the ABC-Bleeding score compared to HAS-BLED score in an independent "real-world" anticoagulated AF patients with long-term follow-up...
August 11, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28796572/endoglin-and-alk1-as-therapeutic-targets-for-hereditary-hemorrhagic-telangiectasia
#2
Lidia Ruiz-Llorente, Eunate Gallardo-Vara, Elisa Rossi, David M Smadja, Luisa M Botella, Carmelo Bernabeu
Hereditary Haemorrhagic Telangiectasia (HHT) is as an autosomal dominant trait characterized by frequent nose bleeds, mucocutaneous telangiectases, arteriovenous malformations (AVMs) of the lung, liver and brain, and gastrointestinal bleedings due to telangiectases. HHT is originated by mutations in genes whose encoded proteins are involved in the transforming growth factor β (TGF-β) family signalling of vascular endothelial cells. In spite of the great advances in the diagnosis as well as in the molecular, cellular and animal models of HHT, the current treatments remain just at the palliative level...
August 10, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28764591/segmental-colectomy-for-bleeding-diverticular-disease-guided-by-the-peep-test
#3
Vijay Naraynsingh, Shamir O Cawich, Dale Hassranah, Feisal Daniel, Ravi Maharaj, Patrick Harnarayan
Many patients with massive lower gastrointestinal (GI) haemorrhage from diverticulosis are subjected to total colectomy when preoperative localisation is unavailable. We dissected colectomy specimens and noted that there was limited retrograde reflux in most of these cases. Therefore, we sought to assess the value of a positive endoluminal erythrocyte presence (PEEP) test (presence of fresh blood in the caecum) to direct segmental colectomies in 14 patients who required emergency operations for massive lower GI haemorrhage...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28720692/primary-greater-omental-gist-presenting-with-acute-intra-abdominal-haemorrhage
#4
Shariful Islam, Devin Hosein, Vinoo Bheem, Patrick Harnarayan
Primary omental gastrointestinal stromal tumours (GISTs) are classified as extra-GISTs with a reported incidence of <1% of all GISTs. There are only a few cases in the English literature reporting omental GIST with none reporting acute intra-abdominal haemorrhage as a presenting feature. We report a case of a 67-year-old man who presented with haemorrhage from a primary omental GIST requiring emergency laparotomy.
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28712008/acute-lower-gastrointestinal-haemorrhage-outcomes-and-risk-factors-for-intervention-in-949-emergency-cases
#5
Kheng-Seong Ng, Natasha Nassar, Deanne Soares, Patrick Stewart, Marc A Gladman
PURPOSE: Outcomes of acute lower gastrointestinal haemorrhage (ALGIH) are mostly derived from studies performed in the sub-acute/elective rather than the emergency department (ED) setting. The aims of this study were to determine the incidence and outcomes of patients presenting to a tertiary hospital ED with ALGIH and to identify associated clinicopathological risk factors. METHOD: A retrospective observational cohort study of consecutive patients presenting with ALGIH to a tertiary hospital ED was performed...
July 15, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28700711/non-vitamin-k-oral-anticoagulants-are-non-inferior-for-stroke-prevention-but-cause-fewer-major-bleedings-than-well-managed-warfarin-a-retrospective-register-study
#6
Vilhelm Sjögren, Björn Byström, Henrik Renlund, Peter J Svensson, Jonas Oldgren, Bo Norrving, Anders Själander
BACKGROUND: For patients with atrial fibrillation, non-vitamin K oral anticoagulants, or NOACs (dabigatran, rivaroxaban, edoxaban, and apixaban) have been proven non-inferior or superior to warfarin in preventing stroke and systemic embolism, and in risk of haemorrhage. In the pivotal NOAC studies, quality of warfarin treatment was poor with mean time in therapeutic range (TTR) 55-65%, compared with ≥70% in Swedish clinical practice. METHODS: We compared NOACs (as a group) to warfarin in non-valvular atrial fibrillation, studying all 12,694 patients starting NOAC treatment within the Swedish clinical register and dosing system Auricula, from July 1, 2011 to December 31, 2014, and matching them to 36,317 patients starting warfarin using propensity scoring...
2017: PloS One
https://www.readbyqxmd.com/read/28665206/primary-aorto-enteric-fistula-as-a-rare-cause-of-massive-gastrointestinal-haemorrhage
#7
Christian-Alexander Behrendt, Sabine Wipper, Sebastian E Debus, Yskert von Kodolitsch, Klaus Püschel, Michael Kammal, Anna Kammal
The incidence of primary aorto-enteric fistula (PAEF) is low with only few case reports and case series published. Depending on the location of the PAEF, the perforation leads to upper or lower gastrointestinal haemorrhages. We conducted a MEDLINE search according to the PRISMA statement. Articles with publication dates from 2000 to 2016 were included and present an own case report. We considered all case reports and series reporting on PAEF and identified 85 individual patients from 32 case reports and five case series...
June 30, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28651669/gastrointestinal-haemorrhage-due-to-lymphangiectasia-caused-by-protein-losing-enteropathy-in-the-fontan-circulation
#8
Pauline Gras, Frédéric Gottrand, François Godart
We report the case of a 14-year-old boy with severe protein-losing enteropathy after Fontan surgery that led to lymphangiectasia, which caused gastrointestinal haemorrhage and required invasive treatment to stop the bleeding. Through this case and a review of the literature on protein-losing enteropathy after Fontan surgery, we highlight a rare and serious presentation of the disease and the difficulties of diagnosis and management.
June 27, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28647788/the-efficacy-and-safety-of-two-low-dose-peri-operative-dexamethasone-on-pain-and-recovery-following-total-hip-arthroplasty-a-randomized-controlled-trial
#9
Yi-Ting Lei, Bin Xu, Xiao-Wei Xie, Jin-Wei Xie, Qiang Huang, Fu-Xing Pei
PURPOSE: To evalute the efficacy and safety of two low-dose peri-operative dexamethasone on pain and recovery following total hip arthroplasty (THA). METHODS: One hundred ten patients received two-dose of 10 mg IV-dexamethasone (group dexa) or IV-isotonic saline (group placebo). The level of C-reactive protein (CRP) and interleukin-6 (IL-6), pain at rest and during mobilization, incidence of post-operative nausea and vomiting (PONV), intensity of nausea, post-operative fatigue, consumption of analgesic and antiemetic rescue, range of motion (ROM), post-operative length of stay (post-operative LOS), wound problems and complications were recorded and compared...
June 25, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28640322/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-for-treatment-and-prevention-of-recurrence-of-venous-thromboembolism
#10
Craig I Coleman, Craig Coleman, Thomas J Bunz, Alexander G G Turpie
The efficacy and safety or rivaroxaban versus enoxaparin/vitamin K antagonist for treatment and prevention recurrence of venous thromboembolism (VTE) was demonstrated in the randomised EINSTEIN trials. We assessed the effectiveness and safety of rivaroxaban versus warfarin in VTE patients managed in routine practice. Using US MarketScan claims from 1/2012-6/2015, we included adults with a primary diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) during a hospitalisation/emergency department visit, newly-initiated on rivaroxaban or warfarin within 30-days after the VTE and with ≥180-days of continuous medical/prescription benefits prior to the VTE (baseline)...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28622955/age-specific-risks-severity-time-course-and-outcome-of-bleeding-on-long-term-antiplatelet-treatment-after-vascular-events-a-population-based-cohort-study
#11
Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell
BACKGROUND: Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70-90%, uptake is low and guidelines are conflicting...
July 29, 2017: Lancet
https://www.readbyqxmd.com/read/28619975/antibiotic-associated-haemorrhagic-colitis-not-always-clostridium-difficile
#12
Olalekan Akanbi, Nasir Saleem, Mohanad Soliman, Bibek Singh Pannu
Antibiotic-associated colitis is a gastrointestinal complication of antibiotic use commonly seen in hospitalised patients, with Clostridium difficile (C. difficile) colitis being the most common type. We present a case of haemorrhagic colitis secondary to Klebsiella oxytoca following self-initiated amoxicillin-clavulanic acid use. An 85-year-old woman presented to the emergency department with abdominal pain and mucobloody diarrhoea. History was notable for an ongoing 5-day course of amoxicillin-clavulanic acid use...
June 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28606079/costs-of-major-intracranial-gastrointestinal-and-other-bleeding-events-in-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#13
Marie Jakobsen, Christophe Kolodziejczyk, Eskild Klausen Fredslund, Peter Bo Poulsen, Lars Dybro, Søren Paaske Johnsen
BACKGROUND: Use of oral anticoagulation therapy in patients with atrial fibrillation (AF) involves a trade-off between a reduced risk of ischemic stroke and an increased risk of bleeding events. Different anticoagulation therapies have different safety profiles and data on the societal costs of both ischemic stroke and bleeding events are necessary for assessing the cost-effectiveness and budgetary impact of different treatment options. To our knowledge, no previous studies have estimated the societal costs of bleeding events in patients with AF...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28588761/apixaban-concomitant-medicines-and-spontaneous-reports-of-haemorrhagic-events
#14
Gillian E Caughey, Lisa M Kalisch Ellett, John D Barratt, Sepehr Shakib
INTRODUCTION: Little is known about the potential safety issues associated with apixaban in clinical practice and their reporting in spontaneous adverse event (SAE) databases. OBJECTIVE: To describe SAE reports associated with the oral anticoagulant apixaban from Australia, Canada and USA and to examine associated concomitant medicine use. METHODS: SAE report databases from Australia, Canada and the USA were examined for all reports of adverse events associated with apixaban and concomitant medicines from 1 January 2012 to 30 September 2014...
May 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28560130/fatal-haemorrhagic-duodenal-mucormycosis-in-a-non-immunocompromised-host-a-case-report
#15
Simbarashe G Mungazi, Blessing Zambuko, David Muchuweti, Edwin G Muguti, Sizolwenkosi Mlotshwa
Mucormycosis is an opportunistic infection caused by the fungi of the Mucorales order of the class Zygomycetes. Gastrointestinal mucormycosis is an uncommon, fatal condition accounting for only 7% of the cases. We present the case of a gastroduodenal mucormycosis presenting as recurrent massive hematemesis. We report this case to alert clinicians of this rare but fatal condition and to encourage further research into its pathogenesis and management.
September 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28559387/haemobilia-due-to-hepatic-artery-pseudoaneurysm
#16
Cristina Teixeira, Suzane Moura Ribeiro, Ana Luisa Alves, Isabelle Cremers
An 83-year-old woman with a history of hepaticoduodenostomy 20 years ago was admitted with upper gastrointestinal bleeding. Emergency upper gastrointestinal endoscopy revealed multiple blood clots over the stomach and first and second parts of the duodenum. The cannulation of the biliary tree with a flexible end-viewing endoscope exposed the presence of blood clot inside biliary lumen and a semipedunculated polyp which, at first, appeared to be the cause of haemorrhage. A few days after polypectomy, patient was discharged home, however, was admitted again with massive bleeding and selective angiography demonstrated a pseudoaneurysm of left hepatic artery...
May 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28540489/endoscopy-in-patients-on-antiplatelet-agents-and-anticoagulants
#17
REVIEW
Andrew M Veitch
Management of patients on anticoagulant or antiplatelet therapy undergoing endoscopy presents a balance of risks between haemorrhage due to the procedure, and thrombosis due to discontinuation of antithrombotic therapy. Haemorrhage is usually controllable endoscopically, but thrombosis could, on occasion, result in myocardial infarction or stroke, with permanent disability or death. For elective procedures, there is adequate time to plan best management of antithrombotic therapy. International guidelines have been published, but recommendations are based on limited evidence and consultation with appropriate medical specialists, and the patient is important...
June 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28506132/lanreotide-in-the-management-of-small-bowel-angioectasias-seven-year-data-from-a-tertiary-centre
#18
S Chetcuti Zammit, D S Sanders, R Sidhu
BACKGROUND AND AIMS: Haemorrhage from small bowel angioectasias (SBAs) can be debilitating to patients who are very often elderly and have multiple comorbidities. Our aim was to assess the use of lanreotide in addition to endotherapy in patients with SBAs. METHOD: Patients with SBAs on capsule endoscopy (CE) who received lanreotide injections from January 2010 to till the present day at the Royal Hallamshire Hospital in Sheffield were included. Baseline demographics were recorded...
May 16, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28487617/endoscopic-ultrasound-guided-cutting-of-holes-and-deep-biopsy-for-diagnosis-of-gastric-infiltrative-tumors-and-gastrointestinal-submucosal-tumors-using-a-novel-vertical-diathermic-loop
#19
Yu-Mei Liu, Xiu-Jiang Yang
AIM: To report on a more accurate diagnostic possibility offered by endoscopic ultrasound-guided cutting of holes and deep biopsy (EUS-CHDB) for pathologic diagnosis of gastric infiltrative tumors and gastrointestinal submucosal tumors. METHODS: Ten consecutive patients who were suspected of having gastric invasive tumors or gastrointestinal submucosal tumors underwent EUS-CHDB with a novel vertical diathermic loop. We reviewed their medical data and analysed the effectiveness and safety of this new method...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28486159/trends-of-thromboprophylaxis-and-complications-after-major-lower-limb-orthopaedic-surgeries-in-korea-national-health-insurance-claim-data
#20
Sunyoung Kim, Hongyup Ahn, Soon-Ae Shin, Jong-Heon Park, Chang Won Won
BACKGROUND: In Western countries, prophylaxis for venous thromboembolism (VTE) following major lower limb orthopaedic surgeries is recommended. However, that has not been the case in Asian countries, where the reported incidence of postoperative VTE has been low. The present study examined trends in VTE prophylaxis prescriptions and related complications following major lower limb orthopaedic surgeries in South Korea. DESIGN/PARTICIPANTS: Using claim data from the National Health Insurance Corporation, 263,664 patients aged 65years or older who underwent major orthopaedic surgeries (total hip arthroplasty [THA], total knee arthroplasty [TKA], or hip fracture surgery [HFS]) between 2008 and 2012 were included...
April 26, 2017: Thrombosis Research
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